Early expressions of psychopathology and risk associated with trans-diagnostic transition to mood and psychotic disorders in adolescents and young adults
Year: 2021
Type: article
Study design: Observational Study
Abstract: OBJECTIVES: The heterogeneity and comorbidity of major mental disorders presenting in adolescents and young adults has fostered calls for trans-diagnostic research. This study examines early expressions of psychopathology and risk and trans-diagnostic caseness in a community cohort of twins and non-twin siblings. METHODS: Using data from the Brisbane Longitudinal Twin Study, we estimated median number of self-rated psychiatric symptoms, prevalence of subthreshold syndromes, family history of mood and/or psychotic disorders, and likelihood of subsequent trans-diagnostic caseness (individuals meeting diagnostic criteria for mood and/or psychotic syndromes). Next, we used cross-validated Chi-Square Automatic Interaction Detector (CHAID) analyses to identify the nature and relative importance of individual self-rated symptoms that predicted trans-diagnostic caseness. We examined the positive and negative predictive values (PPV; NPV) and accuracy of all classifications (Area under the Curve and 95% confidence intervals: AUC; 95% CI). RESULTS: Of 1815 participants (Female 1050, 58%; mean age 26.40), more than one in four met caseness criteria for a mood and/or psychotic disorder. Examination of individual factors indicated that the AUC was highest for subthreshold syndromes, followed by family history then self-rated psychiatric symptoms, and that NPV always exceeded PPV for caseness. In contrast, the CHAID analysis (adjusted for age, sex, twin status) generated a classification tree comprising six trans-diagnostic symptoms. Whilst the contribution of two symptoms (need for sleep; physical activity) to the model was more difficult to interpret, CHAID analysis indicated that four self-rated symptoms (sadness; feeling overwhelmed; impaired concentration; paranoia) offered the best discrimination between cases and non-cases. These four symptoms showed different associations with family history status. CONCLUSIONS: The findings need replication in independent cohorts. However, the use of CHAID might provide a means of identifying specific subsets of trans-diagnostic symptoms representing clinical phenotypes that predict transition to caseness in individuals at risk of onset of major mental disorders.
Source: PLoS ONE
Language: English
Subfield: Experimental and Cognitive Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $1,749
Funders: Pfizer, AstraZeneca, Norges Teknisk-Naturvitenskapelige Universitet, Australian Government, National Research Foundation, Mental Health Commission, Danmarks Grundforskningsfond, University of Sydney, University of Queensland, Servier, National Mental Health Commission, Medical Research Council, National Health and Medical Research Council, Ciência sem Fronteiras
Awards: Can infection, low vitamin D and stress cause mental illness in young adults?, Advancing our understanding of the genetics of Psychiatric and Neurological Disease, The Brisbane Longitudinal Twin Study: Finding genes for common diseases, Advancing our understanding of Psychiatric Disorders through Imaging and Genetics, G3877536995, G4989369042, G5188638239, G5745092821, Modifiable risk factors for Serious Mental Illness - an integrated program of epidemiology, genetics and clinical trials, Early intervention for mood disorders, G8301805061
OpenAlex ID: W3164910755